“Mobile healthcare, or mHealth, can be broadly defined as the “delivery of healthcare services via mobile communication devices.” More specifically, mHealth refers to the delivery, facilitation and communication of health-related information via mobile telecommunication and multimedia technologies – including cell phones, tablet devices, PDAs and wireless infrastructure in general”

I think this is incorrect. mHealth is the leveraging of MOBILE (the newest mass media) for healthcare. The difference is subtle but important so please visit the post I link to if you need to. The definition offered by the report fails on several areas that are going to be important going forward eg many of the devices that will make up the mHealth landscape will not be “mobile communication devices“. Examples of this may be M2M products like 3G connected Weighing Scales (that won’t be mobile) or QR Codes/machine readable packaging (shown in following image) that you will increasingly find embedded into pharma packaging over the next few years.

“While the concept of eHealth, or electronic-based healthcare services, is closely related to mHealth by definition, “eHealth” can largely be viewed as the technology that supports the functions and delivery of healthcare, while mHealth rests largely on providing healthcare access. For example, a project labeled “mHealth” that uses mobile devices to access data on HIV/AIDS information would require an eHealth system to manage, store, and assess the data. Thus, “eHealth” projects many times operate as the backbone of mHealth projects”

This statement confirms that the author doesn’t understand the difference between e and mHealth and merely thinks mHealth is some little brother. This is natural and we saw it when other mass media’s were introduced eg. initally cinema screen advertisers combined their radio ad (as the sound track) with their newspaper print advert mistakenly thinking that would be the way to leverage the new communication opportunities.

To take the HIV example: Most people with HIV live in emerging markets. In many emerging markets the mobile phone is THE most popular means of accessing the internet. In many emerging markets Mobile Data is the big brother eg. 70% of total internet traffic is mobile internet traffic.

Certainly in the case of HIV: mHealth is to eHealth as mMoney is to eMoney. Bigger, brighter, and a much bigger opportunity. It might be difficult to see/measure the mHealth opportunity (that’s one of the reasons I write this blog) but it’s abundantly clear when we look at the scale of volumes passing through mPesa in Kenya Vs electronic money transfers (which are much smaller due to the high % of unbanked, greater convenience etc).

Claiming that ““eHealth” can largely be viewed as the technology that supports the functions and delivery of healthcare, while mHealth rests largely on providing healthcare access” is like saying we need a Tail to wag a Dog. Yes they’re linked but isn’t it obvious that the one with the 6 billion individual endpoints is going to be more important and presents the bigger opportunities?

The report then goes on to suggest “more advanced concepts like remote monitoring and real-time communication between patient and physician are just starting to emerge“. Scatching my head and trying to think back to the last time I met a clinician who actually consults with patients (ie. discount all the Public Health Doctors etc) who didn’t have a mobile phone and doesn’t use it to talk with patients all the time I realised my report on this report was going to be longer than the document itself.

From reading on it became clear that the document was a means to sell MobileStorm’s “secured mobile messaging” service that has already been deployed as a pilot with Kaiser Permanente:

“The concept of secured mobile messaging is easier said than done, however, which is why most mHealth solutions that utilize mobile messaging focus on basic communication like appointment and prescription reminders via SMS. Finding a way to secure this communication opens up numerous additional possibilities. At present, a clinic can send an SMS notification to an opted-in user saying something like, “Your lab results are ready,” which provides a convenience for the consumer but still limits the advantages. Upon receiving the message, the consumer would still need to call or visit the clinic to receive the full results of their lab testing. With secured mobile messaging, that same SMS could read: “Your lab results are ready, visit this secured link
see your results.” SMS can act as the gateway to a secured, direct connection to your healthcare provider to send and receive health information in real-time with little intervention on both the consumer and clinician side. Through the integration of secured mobile landing pages and SMS, numerous layers of security and privacy-consent can exist, which in turn satisfies many compliance, privacy and security concerns”

This is misleading and could result in unnecessary scare mongering. Claiming that “Once a solid, standardized and secured mobile messaging ecosystem emerges, it will act as a foundation and building block to many innovative solutions in the future, many of which are largely unrealized at this point” suggests that there is a major security reason preventing Kaiser Permanente working with engaged patients via normal SMS messages (that they communicate clearly). For example:

I fear that suggesting otherwise may well drive some MobileStorm sales enquiries but could delay adoption of efficient new ways of communicating with patients that leverage the devices that are already in pockets.

2 Responses to Review of MobileStorm “2011 mHealth Report”

David I want to start out first by saying thanks for taking the time to review our mHealth report, even if you didn’t fall out of your chair 🙂 I think you make some valid points. I do want to point out that we commissioned a top notch firm to do the bulk of the research and we reorganized that research into this report. They really did a great job with their research, taking to many companies and VCs about where they believe the market is headed and what they are investing in. I have to say it was very hard finding good data, which is one of the reasons we decided to talk about what we did with Kaiser.

There is virtually no case studies on the market that have as much detail about the success of the program. Sure it toots our horn and helps the PR machine, but the data is really solid.

Finally there is no secure SMS technology for consumers. A message sent from the carrier to the consumer is not encrypted. Healthcare organizations want to have meaningful conversations with their members and this means being able to include PHI in their mobile messaging. We have a solution so that communication can be encrypted and organizations can send PHI. It is very exciting stuff and the industry is set to take off.

I agree SMS is not a secure technology for consumers but we shouldn’t be discouraging it’s use by providers and patients because of this.

The technology you are proposing is a proprietary communication application and is not SMS based so comparing the two is slightly unfair eg. it would be fairer to compare it with secure mobile internet access which is much more accessible and doesn’t require a download before customers can avail of it.

IMO instead of talking about the insecurity of SMS we’d do better to help healthcare providers appreciate the opportunity and limitations. Here are some good examples:

It is now proven that it is popular and offers benefits when used for emergency’s by people who are deaf or have speech difficulties: http://bit.ly/f30ltI

It is now proven that it can help patients remember to attend clinic appointments and clinics to manage the problems of DNA’s: http://bit.ly/i97VVx

Be mindful that there are lots of ways that you can use SMS with patients that respect their privacy eg. flash SMS’s that ask patients to log on to the secure generic online portal of a provider (we do this at 3G Doctor to inform patients of their written report following a consultation for example).